Fibromyalgia and Alcohol: Should we drink or not?

Raise a glass—one glass that is—and say cheers. People with fibromyalgia can consume alcoholic beverages socially, in low to moderate levels, and possibly even feel an improvement in symptoms. With one caveat regarding fibromyalgia and alcohol: Those imbibing should not also be taking sedatives, opioids, muscle relaxers or other medications for a coexisting disease or whatnot that can interact with alcohol.

Fibromyalgia and Alcohol

Alcohol boosts γ-Aminobutyric Acid (GABA) levels, which tend to be low in patients with fibromyalgia. Unfortunately, the FDA has not approved a drug that does the same thing that alcohol does with GABA levels. However, there are drugs approved by the FDA for the condition, and other new drugs are being explored and developed.

Daniel Clauw, MD, from the University of Michigan Medical School, is a coauthor of a study on fibromyalgia and alcohol, published in Arthritis Research & Therapy. The study found that low to moderate alcohol consumption may lower fibromyalgia symptoms and improve quality of life compared to no alcohol consumption or high alcohol consumption. Though the study was published in 2013, he says the research still stands today in 2017.

“Our study prompted Dr. Macfarlane in Scotland to look in large epidemiologic databases to see if he could find a similar association and he did. His data similarly showed that low alcohol consumption was protective against fibromyalgia symptoms compared to no or high alcohol consumption.”

The study on fibromyalgia and alcohol, which was published in Arthritis Care & Research, found that people who had chronic widespread pain were less likely to say their symptoms were disabling if they also consumed alcohol up to a moderate level.

When asked if low to moderate drinking is something that can benefit people with fibromyalgia, depending on the medications they take, Dr. Clauw says “Perhaps. They might want to at least give it a try to have a single drink a few hours before bedtime to see if they feel any better.”

Not all medical professionals, though, like suggesting that alcohol can be used to reduce fibromyalgia pain/symptoms.

The past president of the American Academy of Pain Medicine, Lynn Webster, MD, says, “I think that a mild to moderate amount of alcohol is probably not going to be harmful to most patients. But I think it is another step to suggest that it be used for pain.”

Dr. Webster says that with the chronic use of alcohol, tolerance will develop and you have to increase the dose just like opioids. “That is kind of a slippery slope.” He also says that because alcohol is a rewarding substance, a subset of people who are exposed to alcohol end up having an alcohol use disorder. “They can become alcoholics.”

Another risk is drug-drug interactions. (You can check drug interactions at drugs.com and Medscape.com, or ask your pharmacist.) Dr. Webster says sedatives, muscle relaxers, opioids, and any drug taken for a coexisting medical condition can interact with alcohol. “It can get out of control and I think it can be very dangerous, particularly if somebody is taking other medications along with alcohol.”

While drinking alcohol may help symptoms for a while, Dr. Webster says, “I think it is just not prudent to recommend alcohol. If they are my patients and if they were to ask me if they could consume alcohol, it depends…. I would say in moderation alcohol can be used in people with fibromyalgia just like it can be used in people without fibromyalgia. But it should not be used to treat pain.”

So how much is okay? “If somebody has one or two glasses of wine and/or three or four per week, that would probably be acceptable. But that has to be individualized. For some people that is too much.”

Fortunately, hope is on the horizon when it comes to treatments for fibromyalgia pain and other symptoms.

“There are a number of medications in development that might be significant improvements to what is available today,” says Dr. Webster. Taking it further, he adds, “I see a day when there will be a cure for fibromyalgia.”